A trauma-focused intensive outpatient program integrating elements of exposure therapy with acceptance and commitment therapy: Program development and initial outcomes

Melissa W. Ramirez, Craig A. Woodworth, Wyatt R. Evans, Gerard A. Grace, Richard P. Schobitz, Sara A. Villarreal, Christopher J. Howells, Roy D. Gissendanner, Nicholas J. Katko, Kelli N. Jones, Amanda E. McCabe, Donna J. Terrell

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

A Performance Improvement project conducted within Army Behavioral Health identified significant challenges associated with treating service members diagnosed with posttraumatic stress disorder (PTSD) including unavailability of frequent and consistent therapy, a low completion rate of evidence-based treatment, and a high non-response rate. In response to these findings, clinical staff at Brooke Army Medical Center developed an intensive outpatient program for the treatment of PTSD and combined Acceptance and Commitment Therapy with Prolonged Exposure therapy to create an integrative and uniquely tailored intervention. This project included 311 active duty service members who had not made significant progress in individual outpatient therapy for PTSD. Each participant completed pre- and post-treatment measures of symptoms, functioning, and processes related to psychological flexibility. Program evaluation also included participant interviews, survey responses, and clinician reports. Overall, the program was tolerable and reviewed favorably by participants. Preliminary pre-post treatment analyses revealed, on average, large reductions in PTSD symptoms as well as significant changes in the target direction on nine of ten outcome measures. These findings encourage further investigation of process-outcome relationships and future, rigorous implementation studies of ACT and exposure integration and culturally and contextually sensitive treatments for military-related PTSD.

Original languageEnglish (US)
Pages (from-to)66-72
Number of pages7
JournalJournal of Contextual Behavioral Science
Volume21
DOIs
StatePublished - Jul 2021
Externally publishedYes

Keywords

  • Acceptance and commitment therapy
  • Combat trauma
  • Exposure therapy
  • Military behavioral health
  • Military sexual trauma
  • PTSD

ASJC Scopus subject areas

  • Health(social science)
  • Ecology, Evolution, Behavior and Systematics
  • Applied Psychology
  • Organizational Behavior and Human Resource Management
  • Behavioral Neuroscience

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